Please read all pages of
the program rules and instruction. This form may be photocopied but only if
accompanying pages of the program rules and instructions are also included.

To apply for a scholarship,
complete this application form and mail completed application and attachments
to Mrs. Peggy Elliott, Chairman, National Federation of the Blind Scholarship
Committee, 805 Fifth Avenue, Grinnell, Iowa 50112; (641) 236-3366. Form must
be received by March 31, 2005.

Name (please include any
maiden or other names by which you have been known):

Please see the following
list of required attachments. If you received only this portion of the application
form, please request complete application and rules from the above address or
www.nfb.org.

Fill out the application
and attach the following documents or arrange to have them sent to the Scholarship
Committee:

1. Personal Letter from
Applicant. NFB scholarships are awarded on the basis of scholastic excellence,
financial need, and community service. In preparing your personal letter, keep
in mind that the committee members are all successful blind college graduates.
Consider how you can most effectively convey your best qualities. Since the
awards are restricted to blind people, the committee will be interested in the
techniques and approaches you use. Almost all blind students have financial
need. Committee members will assume basic need, so you may choose merely to
refer to this topic unless your need is unusual.

2. Two letters of recommendation.

3. Current transcript
from institution now attending and transcripts from all other postsecondary
institutions attended. If you have not yet attended such an institution or have
not completed one year of study, send high school transcript.

4. Letter from a Federation
state president or designee. The Federation has affiliates in every state.
Some state presidents write the letters personally; others assign them to officers
and board members. Federation state presidents and their designees are volunteers.
Many take messages and then return calls in evenings or on weekends. They will
wish to speak with applicants personally; parents or school officials may help
set up appointments but cannot do the actual interviews. Most state presidents
and their designees send scholarship letters directly to the Scholarship Committee,
where they are added to the student’s file along with transcripts and other
materials mailed separately. Applicants should mail materials to the Scholarship
Committee and should check that the interviewer’s letter is sent. If you do
not know the name or phone number of your state president, call the scholarship
office at (641) 236-3366 for this information. If you live in one state and
attend school in another, you may contact either state president.

5. Score Reports
(for high school seniors only). Please attach a copy of your score reports for
all standardized tests taken for college admission. Copies are acceptable; there
is no need to attach official reports.

NATIONAL
FEDERATION OF THE BLIND 2005 SCHOLARSHIP PROGRAM

Each year at its National
Convention in July, the NFB gives a broad array of scholarships to recognize
achievement by blind scholars. All applicants for these scholarships must be
(1) legally blind and (2) pursuing or planning to pursue a fulltime, postsecondary
course of study in a degree program at a United States institution in the fall
of 2005, except that one scholarship may be given to a fulltime employee also
attending school part-time. In addition, some scholarships have been further
restricted by the donor. Each applicant will be considered for all scholarships
for which he or she qualifies. The scholarship application deadline is March
31, 2005. Scholarships to be given at the National Convention in 2005 are listed
with special restrictions noted:

1 SCHOLARSHIP FOR $12,000

Kenneth Jernigan Scholarship—Given
by the American Action Fund for Blind Children and Adults, a nonprofit organization
which works to assist blind people, in memory of the man who changed perceptions
regarding the capabilities of the blind in this country and throughout the world.
Kenneth Jernigan is viewed by our field as the most important figure in the
20th century in the lives of blind people. The Action Fund wishes to keep fresh
and current in the 21st century the understandings he brought to the field and
thus has endowed this scholarship dedicated to his memory and to the continuation
of the work he began. No additional restrictions.

1 SCHOLARSHIP FOR $10,000

Charles and Melva T.
Owen Memorial Scholarship—First established by Charles Owen in loving memory
of his blind wife and now endowed by his last will and testament to honor the
memory of both. In founding the scholarship, Charles Owen wrote: “There shall
be no limitation as to field of study, except that it shall be directed towards
attaining financial independence and shall exclude religion and those seeking
only to further general or cultural education.”

2 SCHOLARSHIPS, EACH
FOR $7,000

Two National Federation
of the Blind Scholarships—No additional restrictions.

4 SCHOLARSHIPS, EACH
FOR $5,000

Hank LeBonne Scholarship—Hank
LeBonne was a man who loved life and loved the National Federation of the Blind.
His last wish was that his remaining assets be used to help young blind men
and women have the same opportunities in life he enjoyed. No additional restrictions.

Jennica Ferguson Memorial
Scholarship —Given to keep alive the memory of a young woman who dealt with
her blindness and terminal illness with a grace and strength she frequently
assured others she drew from the Federation and from her faith in God. No additional
restrictions.

Michael and Marie Marucci
Scholarship —Given by two dedicated and valued members of the NFB of Maryland.
The winner of this scholarship must be studying a foreign language or comparative
literature; pursuing a degree in history, geography, or political science with
a concentration in international studies; or majoring in any other discipline
requiring study abroad. The winner’s file must also show evidence of competence
in a foreign language.

Sally S. Jacobsen Scholarship—Endowed
in loving memory of a long-time New York State leader by her husband Carl and
family and by many others who wish to commemorate Sally’s indomitable spirit;
education (education of disabled youth preferred); no additional restrictions.

22 SCHOLARSHIPS, EACH
FOR $3,000

Hermione Grant Calhoun
Scholarship—Dr. Isabelle Grant endowed this scholarship in memory of her
daughter. Winner must be a woman.

Kuchler-Killian Memorial
Scholarship—Given in loving memory of her parents, Charles Albert Kuchler
and Alice Helen Kuchler, by Junerose Killian, dedicated member of the NFB of
Connecticut. No additional restrictions.

E. U. Parker Scholarship—Endowed
by his wife, who joined him in a lifetime of Federationism, this scholarship
honors a long-time leader of the National Federation of the Blind whose participation
stood for strong principles and strong support of the Federation’s work. No
additional restrictions.

Howard Brown Rickard
Scholarship—Winner must be studying or planning to study in the fields of
law, medicine, engineering, architecture, or the natural sciences.

National Federation
of the Blind Computer Science Scholarship—Winner must be studying in the
computer science field.

National Federation
of the Blind Educator of Tomorrow Award—Winner must be planning a career
in elementary, secondary, or postsecondary teaching.

Sixteen National Federation
of the Blind Scholarships—No additional restrictions.

All scholarships awarded
to blind women which are not otherwise endowed are made possible by a generous
bequest from the estate of Dorothy R. Olson.

CRITERIA: All scholarships
are awarded for academic excellence, community service, and financial need.

MEMBERSHIP: The National
Federation of the Blind is an organization dedicated to creating opportunity
for all blind people. Recipients of NFB scholarships need not be members of
the National Federation of the Blind.

REAPPLICATION: Those who
have previously applied are encouraged to apply again. It is the intention of
the NFB to award at least three scholarships to men and women who have already
received one Federation scholarship in the past if enough strong and worthy
candidates apply.

WINNERS: The Scholarship
Committee reviews all applications and selects the scholarship winners. These
winners, the same number as there are scholarships to award, will be notified
of the selection by telephone by June 1 and will be brought to the National
Federation of the Blind convention in July at Federation expense. This is in
addition to the scholarship grant. Winners will participate in the entire convention
and in the scheduled scholarship program activities, beginning with functions
on Saturday, July 2, 2005. All decisions by the Scholarship Committee are final.

The National Federation
of the Blind convention is the largest gathering of blind people (more than
2,500) to occur anywhere in the nation each year. You will be able to meet other
blind students and exchange information and ideas. You will also be able to
meet and talk with blind people who are successfully functioning in your chosen
profession or occupation. Federal officials, members of Congress, and the makers
and distributors of new technology attend Federation conventions. Above all,
a broad cross section of the most active segment of the blind population of
the U.S. will be present to discuss common problems and plan for concerted action.
It is an interesting and exciting week.

AWARDS: The day before
the convention banquet the Scholarship Committee will meet to determine which
winners will receive which scholarships. The scholarship awards will be made
during the banquet.

OTHER SCHOLARSHIPS: Many
state affiliates of the National Federation of the Blind also award scholarships,
using eligibility criteria identical to or very similar to the standards for
this national program. Check with your state president about deadlines, criteria,
and levels of scholarships.

ENHANCEMENTS TO THE NATIONAL
PROGRAM: Each year, generous donors add to the amounts listed here, sometimes
for all winners and sometimes for a few. Check on the NFB Web site, www.nfb.org,
to determine if enhancements have been added after this form was printed.